How does air pollution impact our children’s lungs? Read through our fascinating interview with Dr Colin Wallis, Paediatric Respiratory Consultant and Head of Clinical Service in the Respiratory and Transitional Care Unit at Great Ormond Street Hospital.

We asked Colin some of the most frequently asked questions about air pollution and children’s lung health:

1. How exactly does air pollution affect the respiratory system?

Air pollution is an irritant - it’s not supposed to be there in the air we breathe. The lung is designed to take in clean air and breathe out carbon dioxide, and it is not designed to breathe in pollutants. Although the lung works very hard to get rid of pollution, some of these small particle pollutants penetrate deep into the lungs and then cause an inflammatory response. This can make pre-existing lung conditions worse. . But you can also see inflammatory changes in healthy children who can then develop symptoms. 

2. How does air pollution impact children with healthy lungs?

We do not know the long term effects of air pollution on a healthy child’s lungs. What we do know is that the growing healthy child’s lungs have to last a lifetime. You don’t get repair of lung tissue like other organs,; you don’t get another chance at growing new lungs – so you really do not want to insult the growing child’s lungs at an early age with pollutants leading to long term problems in adulthood.. There’s a lot of discussion around the impact of air pollution on those with underlying respiratory conditions, but I think increasingly we need to look at the impact of pollution on a healthy child and their lungs. We really need to ensure that the growing healthy child also breathes clean air keeping healthy lungs healthy into adult life...

3. What concerns you most about air pollution and your patients?

Children with underlying respiratory conditions such as cystic fibrosis, or recurrent chest infections, or asthma, are definitely impacted negatively by air pollution - and of course those who live in inner cities are affected the most. We really do need to make a concerted effort to make sure that the air that these children breathe is not making their conditions worse.

4. Do you often see air pollution impacting the children in your care at Great Ormond Street?

Yes we do, and there’s not just a clinical impression that children who breathe polluted air have difficulties with their lungs. There’s also robust scientific evidence now showing that those children living on roads or attending schools that have high levels of pollution have changes in their lungs and in the sputum from breathing in polluted air.

5. Do you ever talk to your patients or their parents about air pollution?

Parents will often bring it up, especially if they live in high polluted areas. It’s a very difficult situation because you often can’t simply move. You’re living there for a good reason – you’re not living there because it’s polluted. Some families find that their children’s health overrides other concerns and they move, but of course a far better approach would be a more community based attempt to reduce pollutants in those areas so that people can live where they want to.

6. Do you think that air pollution is understood well by parents?

I think there’s an increasing awareness of the difficulties that air pollution can create for children’s lung health. I think that message is getting through and there’s been a much bigger awareness now to let’s say 20 years ago.

7. Are other health professionals also aware of the impacts of air pollution on health?

Yes I think so. Studies that have come out looking at the impact on the lungs and actually documenting the amount of carbon in the lungs of children who are living in high polluted areas. These studies have certainly influenced people’s thinking on the impact of pollution on children’s lung health. Hopefully this knowledge will now extend to policy makers in local and national government.

8. Is there any advice you recommend to your patients or parents? Actions they can take?

Unfortunately, it is beyond my sphere of influence. I can’t dictate to families that they move house because there may well be reasons why they’re living there. This is why National Clean Air Day is really important – to try and highlight the problems and motivate those who can influence these things to make changes.

9. Are you aware of any smaller actions people can take to reduce their exposure?

You’ll see cyclists around London with face masks on to try and prevent inhalation of air pollution. These masks are not particularly effective because air pollution particles are very small and go through a mask – especially when they get damp from exhaled air. Yes, you may keep out the large bits like flies and pollen that you don’t want to go into your mouth and airways, but preventing inhalation of air pollution requires a very expensive and carefully filtered mask which mostly these devices are not.It’s the same with various devices that are placed in the home to “filter” the air. None of them are perfect. A far more effective approach is to work at reducing the pollution within the air we breathe.